A Randomised Controlled Trial To Compare The Efficacy Of Three Different Methods Of Maternal Hydration For Oligohydramnios

Abstract

AIMS To compare efficacy of maternal hydration with oral water, 1L of Ringer lactate( RL) + 1L of 5% Dextrose(5%D) and 2L of 0.45% Normal saline (0.45% NS) in increasing AFI in patients with oligohydramnios. MATERIALS AND METHODS Patients who had been diagnosed as oligohydramnios (with AFI<8) by USG were included in the study. Detailed history of all the patients was taken and complete examination was done. Totally 108 cases were allocated into 3 groups depending on the computer generated randomized table. Group 1(36) was given oral hydration i.e., 2L of water in 2 hours. Group 2(36) received 1L R.L+ 1L 5%Dextorse in 2 hours intravenously and Group 3(36) was given 2L 0.45%NS in 2 hours intravenously. AFI & Symphysiofundal height was assessed after 2 hours and 24 hours after the hydration therapy. RESULTS All the types of hydration therapy had significant increase in AFI and SFH at 2 hours and 24 hours. In group A mean increased from 4.91 ± 1.58(baseline) to 5.88 ± 1.86 and 6.49 ± 2.22 at 2hours and 24 hours respectively. Similarly in group B the mean increased from 4.98 ± 1.86 to 5.79 ± 1.89, 6.18 ± 2.23 at 2 and 24 hours respectively. In group C also these the mean value increased from 5.58 ± 1.31 to 7.32 ± 1.40, 8.32 ± 1.77 at 2 and 24 hours. There was significant increase in group C when compared to other two groups and there was no statistically significant difference x between group A and group B. There was significant rise in SFH in all the three groups at 2 hours and 24 hours. None of the patients had any major side effects. CONCLUSION Both oral and IV hydration with hypotonic solution increases the level of amniotic fluid in cases of oligohydramnios. But 0.45%NS was shown to be significantly better than oral hydration and IV hydration with RL+5%D. SFH can be used to assess the amount of amniotic fluid clinically whenever AFI by ultrasound is not feasible.